How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $44.67 Median $60.26 Typical High $128.82 | Facility | None | $44.67 | $60.26 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $109.65 Typical High $138.04 | Professional | None | $44.67 | $109.65 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $645.65 Typical High $870.96 | Facility | None | $81.28 | $645.65 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $107.15 Typical High $208.93 | Professional | None | $45.71 | $107.15 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
CareSource Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $234.42 | Facility | None | $40.74 | $46.77 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $81.28 Typical High $199.53 | Professional | None | $41.69 | $81.28 | $199.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $32.36 Median $112.20 Typical High $2,089.30 | Facility | None | $32.36 | $112.20 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $50.12 Median $128.82 Typical High $218.78 | Professional | None | $50.12 | $128.82 | $218.78 |
United Setting Professional Modifier None Typical Low $41.69 Median $97.72 Typical High $162.18 | Professional | None | $41.69 | $97.72 | $162.18 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $54.95 Typical High $69.18 | Professional | 52 · Reduced service | $22.39 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $8.91 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $16.60 Typical High $20.89 | Professional | 55 · Aftercare only | $6.76 | $16.60 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $10.96 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.47 | $10.96 | $13.80 |
Where Indiana sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 39th of 51
$105
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.